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find Keyword "胸部肿瘤" 12 results
  • Preoperative Oral Carbohydrate Administration Can Ameliorate Perioperative Stress and Metabolism for Patients with Surgical Thoracic Oncology

    Abstract: Objective To investigate the effect of preoperative oral carbohydrate (CHO) administration on perioperative risks of patients with surgical thoracic oncology,and provide evidence for establishing new scientific preoperative fasting strategy.Methods?In this prospective study, from July to September 2010,32 out of 65 enrolled patients with surgical thoracic oncology in Department 1 of Thoracic Surgery,Cancer Hospital of Peking University, were randomly allocated to preoperative experiment group (fasting overnight and oral 12.5% dextrose 400 ml administration 2 h before anesthesia induction) or control group (fasting overnight and water deprivation from midnight). Clinical data were collected including subjective evaluation of thirst and hunger measured by visual analogue scale (VAS), blood glucose level(BGL),serum insulin level, homeostasis model assessment insulin resistance(HOMA-IR),postoperative length of hospital stay (LOS) and complications.Results?Sixteen patients were enrolled in each group. VAS scores of thirst and hunger of the preoperative experiment group at 1 h before anesthesia induction were significantly lower than those of the control group(24 vs. 49,24 vs. 62 ,P=0.000). BGL(8.59±0.43 mmol/L vs. 5.59±0.43 mmol/L, P=0.000), serum insulin level (24.33±1.80 mIU/ ml vs. 16.28±1.80 mIU/ml, P=0.004)and HOMA-IR(9.23±0.77 vs. 4.03±0.77,P=0.000)of the preoperative experiment group before anesthesia induction were significantly higher than those of the control group,and these three variables of the preoperative experiment group returned to baseline level soon after surgery. There was no statistical difference in postoperative LOS and complication rate between the two groups (P>0.05).Conclusion?Preoperative oral CHO treatment is safe for non-diabetic patients with surgical thoracic oncology, can alleviate their subjective discomfort,decrease insulin resistance, and ameliorate their perioperative stress and metabolism.

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 体外循环辅助下胸部局部晚期肿瘤切除术

    目的 探讨体外循环(CPB)辅助下局部晚期胸部肿瘤切除术的可行性及手术治疗的危险性,总结治疗经验。 方法 回顾性分析2006年8月至2007年8月在我科行体外循环辅助下肿瘤切除术3例患者的临床资料,其中男2例,女1例;平均年龄为31岁(14~43岁)。术前评估均属侵犯心脏、大血管的胸部晚期肿瘤;其中2例行肿瘤完全切除(R0),1例行姑息性切除(R2)。 结果 无住院死亡。平均CPB时间101 min,平均住ICU 时间3 d,平均住院时间15 d;2例术后并发心房颤动、轻度心力衰竭,1例并发肺水肿,均经积极治疗好转出院。术后分别随访14个月、8个月和5个月,生存2例,死亡1例,死于脑转移。 结论 体外循环技术扩大了局部晚期胸部恶性肿瘤(T4期或Ⅳ期)手术的适应证,在能够接受手术风险的基础上给患者带来了希望。

    Release date:2016-08-30 06:06 Export PDF Favorites Scan
  • 机械通气在胸部肿瘤术后急性呼吸衰竭治疗中的应用

    目的 总结胸部肿瘤患者术后发生急性呼吸衰竭(ARF)行机械通气治疗的经验。 方法 根据64例胸部肿瘤患者术后发生ARF的情况,如原发病、手术后的肺疾病、呼吸肌力和手术并发症等进行不同的机械通气治疗,其中61例进行有创通气治疗,3例进行无创性正压通气。对12例肺不张或严重肺部感染者进行床旁纤维支气管镜吸痰、支气管肺泡灌洗(BAL)。 结果 64例ARF中 54例治愈,10例死亡。12例肺不张或严重肺部感染者经纤维支气管镜治疗均有效;随访54例,随访时间2个月,无ARF复发。 结论 胸部肿瘤患者术后发生ARF应选择恰当的通气模式,进行个性化机械通气治疗,良好的机械通气有利于治疗术后并发症;对有肺不张或严重肺部感染者进行纤维支气管镜吸痰和BAL治疗效果良好。

    Release date:2016-08-30 06:09 Export PDF Favorites Scan
  • Application of vascular repair and reconstruction in surgical treatment of superior vena cava syndrome caused by thoracic tumor

    Objective To summarize the clinical experience of vascular repair and reconstruction for treating superior vena cava syndrome (SVCS) caused by thoracic tumor. Methods Between October 2008 and June 2016, 26 patients with thoracic tumor and SVCS were admitted. There were 18 males and 8 females, aged from 27 to 70 years (mean, 45.9 years). Tumor was typed as B1-B3 thymoma in 13 cases, thymic carcinoma in 6 cases, large B-cell lymphoma in 3 cases, T lymphocytic lymphoma in 1 case, malignant teratoma in 1 case, right lung squamous cell carcinoma in 1 case, and carcinoid in 1 case. The tumor diameter ranged from 8 to 15 cm with an average of 10 cm. The patients had different degrees of neck, face, and upper extremity edema, jugular vein distention, and chest wall collateral venous filling. The superior vena cava pressure was 2.45-5.39 kPa. After excision of tumor and invading superior vena cava, 7 patients underwent superior vena cava reconstruction and 19 patients underwent artificial vascular replacement. Results There was no perioperative death, and the symptoms of superior vena cava obstruction were eliminated. Postoperative pulmonary infection, respiratory muscle weakness, and right chylothorax occurred in 4 cases, 1 case, and 1 case respectively. Twenty-four patients were followed up 2-92 months (mean, 37 months), and 2 patients failed to be followed up. At 1, 3, and 5 years, the survival rate was 83.3% (20/24), 41.7% (10/24), and 25% (6/24), respectively. In 6 patients with 5-year survival, there were 1 case of type B1 thymoma, 3 cases of type B3 thymoma, and 2 cases of large B-cell lymphoma. Conclusion For preoperative evaluation of SVCS caused by resectable thoracic tumors, vascular repair and recons-truction technique can be used to quickly and effectively relieve the clinical symptoms and improve the quality of life.

    Release date:2017-03-13 01:37 Export PDF Favorites Scan
  • Investigation of depression and anxiety emotion in perioperative patients with thoracic neoplasms

    Objective To understand the status quo of depression and anxiety emotion in perioperative patients with thoracic neoplasms under the concept of enhanced recovery aftersurgery. Methods Huaxi emotional-distress index scale (HEI) was adopted to investigate the mental status of 195 patients with thoracic neoplasms in Department of Thoracic Surgery, West China Hospital, and the nursing outpatients between September and November in 2016. There were 118 males and 77 females at age of 17–80 (55.72±12.66) years. Results There was significant difference in mental health level between the preoperative patients and the postoperative patients (3.70±3.41vs. 11.01±9.78,P<0.001). The incidence of depression and anxiety emotion in the postoperative patients was significantly higher than that in the preoperative patients (50.00%vs. 9.60%, P<0.001). Besides, there was significant difference of depression and anxiety degree between the preoperative patients and postoperative patients (P<0.001). Moderate to severe depression and anxiety were mostly found in the postoperative patients while mild to moderate depression and anxiety in the preoperative patients. Conclusion Patients with thoracic neoplasms have much emotional obstacle in perioperative period. The incidence and severity degree of depression and anxiety emotion in postoperative patients are higher than those in preoperative patients.

    Release date:2017-11-01 01:56 Export PDF Favorites Scan
  • A study on the status quo and its influencing factors of depression and anxiety in postoperative patients with thoracic neoplasms

    Objective To investigate the status quo and influencing factors of depression and anxiety in postoperative patients with thoracic neoplasms. Methods The general information questionnaire and Huaxi emotional-distress index scale (HEI) were adopted to survey 70 patients after surgery of thoracic neoplasms at the thoracic nursing outpatients from September to November 2016. There were 43 males and 27 females with age of 18-78 (56.20±11.34) years. Results The prevalence rate of depression and anxiety among postoperative patients with thoracic neoplasms was 50.0%, and moderate to severe negative emotions predominated. There was significant difference in educational levels, postoperative hospitalization and postoperative complications (P<0.05), while no significant difference in age, gender, disease types, complicated diseases, surgical procedures, pathological stages and hospitalization expenditures between patients with unhealthy emotions and normal emotions (P>0.05). Conclusion There is a high prevalence rate of negative emotion among postoperative patients with thoracic neoplasms. Educational levels, postoperative hospitalization and postoperative complications are important factors for negative emotion.

    Release date:2017-12-29 02:05 Export PDF Favorites Scan
  • A preliminary discussion on establishment of patient-derived tumor xenograft (PDTX) model and testing of pharmacodynamics

    Objective To establish a patient-derived tumor xenograft (PDTX) model and to observe the latency and rate of tumor formation, tumor size, tumor invasion and metastasis of transplanted tumors. Methods Seven patients with chest tumor in Drum Tower Hospital from April to December 2015 were chosen. There were 5 males and 2 females with age ranging from 61-71 years, including 4 patients of esophageal tumor and 3 patients of lung tumor. PDTX model was established by surgical removal of fresh tumor tissues of these patients and transplantation in NOD-Prkdcem26Il2rgem26Nju subcutaneous (NCG) mice. The latency and rate of tumor formation, tumor size, tumor invasion and metastasis of transplanted tumors were observed, and pathology of HE staining and immunohistochemical testing results were compared between PDTX model and the patients. Results PDTX model was successfully established in 4 patients, and the success rate was 66.7%, including 2 patients of esophageal cancer. The PDTX model retained the differentiation, morphological and structural characteristics of original tumors. Conclusion Pathology and molecular biology characteristics of PDTX model are consistent with the original tumor, which can be an " avatar” of tumor patients for clinical pharmacodynamics screening and new drug research and development.

    Release date:2018-08-28 02:21 Export PDF Favorites Scan
  • Quality control on clinical research in the thoracic oncology

    This article reviewed other literatures in the quality management of clinical trials and summarized author’s experience in quality control of clinical trials which the author conducted as principle investigator over the past years. It provides a reference for fresh investigators before they conduct their own clinical trials.

    Release date:2019-09-18 03:45 Export PDF Favorites Scan
  • Clinical characteristics, diagnosis and treatment of thoracic inflammatory myofibroblastic tumor

    ObjectiveTo explore the clinical characteristics, diagnosis and treatment of thoracic inflammatory myofibroblastic tumor.MethodsThe clinical data, pathological features, treatment and prognosis from 10 patients with thoracic inflammatory myofibroblastic tumor confirmed by pathology were analysed retrospectively from April 2012 to April 2019 at Jiangsu Province Hospital (The First Affiliated Hospital of Nanjing Medical University).ResultsTen participants including six males and four females with a mean age of 37.9 years old. Lesions were detected by physical examination in five patients, cough, chest pain and hemoptysis were the common symptoms. A total of 10 lesions including six in the right lung, three in the left lung and one in the mediastinum. Nine patients were treated with surgery, and one patient received high-frequency electrocautery though rigid bronchoscopy under general anesthesia. All the patients were confirmed by immunohistochemistry, positive rate of smooth muscle actin was 70%, positive rate of anaplastic lymphoma kinase was 70%. The mean follow-up time was 35.9 months, and one patient relapsed the other nine patients were cured.ConclusionsInflammatory myofibroblastic tumor is potentially malignant or low malignant, the clinical manifestations and imaging findings are not specific, once confirmed by pathology, radical surgery is the first choice. For the lesion limited to the airway, interventional therapy could be the choice, but close follow up is needed.

    Release date:2021-01-26 05:01 Export PDF Favorites Scan
  • Opinions on the reclassification of pulmonary adenocarcinoma in situ in the fifth edition of WHO classification of thoracic tumours

    Pulmonary adenocarcinoma in situ is reclassified as precursor glandular lesions in the fifth edition of WHO classification of thoracic tumours, causing widespread attention and heated debate among domestic thoracic oncologists, radiologists, pathologists and surgeons. We would like to comment on the topic and make a few suggestions on the management of pulmonary nodule during lung cancer screening. We are open to all suggestion and welcome debates.

    Release date: Export PDF Favorites Scan
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